The present disclosure relates to apparatus and methods for addressing certain underlying causes of knee pain. Most prior art knee braces are focused on supporting and stabilizing the knee. Some traditional knee braces claim that the stabilization of the patella will alleviate common forms of knee pain such as from patellofemoral syndrome, tendonitis, Osgood Schlatter's disease, osteoarthritis, patellar dislocation, and other like conditions.
However, many research studies have found that these prior art braces are largely ineffective at providing long term pain relief. Moreover, such prior art braces not only do not provide long term relief from pain, but physical symptoms will typically continue to worsen despite use of prior art knee braces.
One of the major reasons that prior art braces are so ineffective in treating knee pain is the failure to address the true cause of knee pain. When it comes to tendonitis, the common belief is that the patella or quadriceps tendon begins to degenerate from overuse. Thus, many braces are focused on putting pressure on those tendons to instill some relief.
However, the underlying problem is not the tendons themselves, but rather is associated with the muscles that attach to those tendons. When muscles are routinely used, they will have a tendency to tighten and shorten in length. When those muscles are shorter, the passive structures in the connective chain suffer as they have to lengthen to accommodate the muscular force. As a result, those tendons become irritated and “overworked”, resulting in knee pain.
Other sources of knee pain are also related to the issue of the “tightened” quadriceps muscle. When the patella is lifted out of its groove by the quadriceps muscle, it will eventually lead to other problems, such as patella femoral syndrome. Patella femoral syndrome is the cause of the start of almost every knee ache or pain. It occurs because the patella no longer rests in its groove where congruent surfaces evenly displace pressure. When the quadriceps muscle becomes shortened or tight, it pulls the patella out of place and forces the patella to rest proximally on the femur. This will inevitably cause achiness and swelling which worsens when the knee is bent while sitting. At 90 degrees of knee bend, this is where the patella will have the most pressure on the bones underneath. Patellar dislocations will also occur frequently, if the quadriceps pulls the patella from its groove. The lateral structures will no longer buttress the patella where it sits, and as a result, will dislocate laterally.
Osteoarthritis in the knee occurs faster in those people who do not stretch their quadriceps muscles because the patella is no longer sitting in its groove and thus rests on non-congruent surfaces. This will result in a faster wear of the cartilaginous cushions underneath the patella which will lead to more bone-on-bone contact.
Osgood-Schlatter's disease may not necessarily occur just from muscle shortening as much as it occurs due to bone lengthening. It occurs because the patella tendon does not stretch, and thus will pull on the bone where a prominent growth will occur. Reduction of stress along the muscles and tendons that attach to that surface will ultimately reduce pain symptoms as well.
The only reason that the condition of “patella alta” or the patella sitting high on the knee has not been more scrutinized is that the diagnostic used to determine patella orientation is the Insall-Salvati ratio, which measures the length of the patella tendon against the overall height of the patella. Because the ratio does not scrutinize the position of the patella, patellar height as a contributing factor to all of these disease processes has not been extensively studied. Instead, lateral displacement of the patella is merely viewed as a contributing cause of pain, or often times, not even recognized as the real issue needing to be addressed.
Moreover, even though prior art braces may rest on the patella, they do not apply any downward force on the patella sufficient to stretch the quadriceps muscle and therefore do not address the underlying cause of knee pain. Therefore, a more effective knee brace for alleviating knee pain is needed.